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  #1  
Old 08-04-2011
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Default Infectious problem???

6 year old boy goes to a picnic with his parents. Upon returning back from the trip the boy experiences a maculopapular rash that starts on the wrist and ankles and involves his palms and soles. Patients temperature is 102.1. Whats the most appropriate Tx?
A...Amoxicilin
B...Ceftriaxone
C...Doxycycline
D...Erythromycin
E...Chloramphenicol

Last edited by Kais_MD; 08-04-2011 at 05:51 PM.
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  #2  
Old 08-04-2011
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Old 08-04-2011
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Originally Posted by Kais_MD View Post
6 year old boy goes to a picnic with his parents. Upon returning back from the trip the boy experiences a maculopapular rash that starts on the wrist and ankles and involves his palms and soles. Patients temperature is 102.1. Whats the most appropriate Tx?
A...Amoxicilin
B...Ceftriaxone
C...Doxycycline
D...Erythromycin
E...Chloramphenicol
rickettsia??
soo doxycycline
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  #4  
Old 08-04-2011
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yeah, rocky mountain spotted fever: doxycycline:

i think chlormaphenicol can also be used, but side effect profile is very severe to warrant usage (bone marrow depression)
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Old 08-04-2011
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You guys are Right..I am surprised no one fell for the fact that you cant use Doxicycline for kids under 8 because of teeth staining...>Sadly i fell for it but the use of chloramphenicol far outweights the cons than simple tooth staining....
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Old 08-04-2011
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You guys are Right..I am surprised no one fell for the fact that you cant use Doxicycline for kids under 8 because of teeth staining...>Sadly i fell for it but the use of chloramphenicol far outweights the cons than simple tooth staining....
i think they use amoxcillin instead of doxycline for less than 8 yrs ,though not sure , i read it somewhere.
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Old 08-04-2011
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i think they use amoxcillin instead of doxycline for less than 8 yrs ,though not sure , i read it somewhere.
Nope..Amoxicilin is approved for lyme Dz in kids Not in Rocky M fever...the only other drug approved was chloramphenicol but it has way too many serious S/E...
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Old 08-04-2011
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You guys are Right..I am surprised no one fell for the fact that you cant use Doxicycline for kids under 8 because of teeth staining...>Sadly i fell for it but the use of chloramphenicol far outweights the cons than simple tooth staining....
directly from the CDC homepage, so that the confusion is cleared..

Doxycycline is the first line treatment for adults and children of all ages and should be initiated immediately whenever RMSF is suspected.

Use of antibiotics other than doxycycline is associated with a higher risk of fatal outcome. Treatment is most effective at preventing death if doxycycline is started in the first 5 days of symptoms.
Doxycycline is the first line treatment for adults and children of all ages:

Adults: 100 mg every 12 hours
Children under 45 kg (100 lbs): 2.2 mg/kg body weight given twice a day
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  #9  
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yeah, an i just read yesterday that chloramphenicol is the DOC for RMSF Tx in pregnancy (because doxycycline is absolutely contraindicated in pregnancy)
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yeah, an i just read yesterday that chloramphenicol is the DOC for RMSF Tx in pregnancy (because doxycycline is absolutely contraindicated in pregnancy)
i dont know....do they still use it....??
i can hear dr goljan say it in my ears...if a doctor prescribes u choramphenicol, he is a bad doctor...
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Old 08-04-2011
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i dont know....do they still use it....??
i can hear dr goljan say it in my ears...if a doctor prescribes u choramphenicol, he is a bad doctor...
i guess something's better than nothing! and moreover, do we have another alternative? It's in uworld that chloramphenicol is used in pregnancy,
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  #12  
Old 08-05-2011
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i guess something's better than nothing! and moreover, do we have another alternative? It's in uworld that chloramphenicol is used in pregnancy,
So final verdict ..>Doxy for everyone and chloramphenicol for pregnant ladies...anyone confirm...
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  #13  
Old 08-05-2011
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So final verdict ..>Doxy for everyone and chloramphenicol for pregnant ladies...anyone confirm...
i concur!!! lol
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